The effect of an educational intervention in early pregnancy with spouse's participation on optimal gestational weight gain in pregnancy: a randomized controlled trial

Asiabar, A Kiani; Shokravi, Farkhondeh Amin; Hajifaraji, Majid; Zayeri, Farid

doi:10.1093/her/cyy040

Cited by 6 publications

(31 citation statements)

References 38 publications

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“…The search identified 7500 studies, of which 178 were retained for full-text review and 28 were included in the present analysis . In the 2017 systematic review, 103 studies were identified, of which 89 were eligible .…”

Section: Resultsmentioning

confidence: 99%

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Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes

et al. 2022

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IMPORTANCE Excessive gestational weight gain (GWG) is common and associated with adverse pregnancy outcomes. Antenatal lifestyle interventions limit GWG; yet benefits of different intervention types and specific maternal and neonatal outcomes are unclear. OBJECTIVE To evaluate the association of different types of diet and physical activity-based antenatal lifestyle interventions with GWG and maternal and neonatal outcomes.DATA SOURCES A 2-stage systematic literature search of MEDLINE, Embase, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, and Health Technology Assessment Database was conducted from February 1, 2017, to May 31, 2020. Search results from the present study were integrated with those from a previous systematic review from 1990 to February 2017. STUDY SELECTION Randomized trials reporting GWG and maternal and neonatal outcomes.DATA EXTRACTION AND SYNTHESIS Data were extracted for random-effects meta-analyses to calculate the summary effect estimates and 95% CIs. MAIN OUTCOMES AND MEASURESOutcomes were clinically prioritized, with mean GWG as the primary outcome. Secondary outcomes included gestational diabetes, hypertensive disorders of pregnancy, cesarean section, preterm delivery, large or small for gestational age neonates, neonatal intensive care unit admission, or fetal death.RESULTS A total of 117 randomized clinical trials of antenatal lifestyle interventions (involving 34 546 women) were included. Overall lifestyle intervention was associated with reduced GWG (−1.15 kg; 95% CI, −1.40 to −0.91), risk of gestational diabetes (odds ratio [OR], 0.79; 95% CI, 0.70-0.89), and total adverse maternal outcomes (OR, 0.89; 95% CI, 0.84-0.94) vs routine care. Compared with routine care, diet was associated with less GWG (−2.63 kg; 95% CI, −3.87 to −1.40) than physical activity (−1.04 kg; 95% CI, −1.33 to −0.74) or mixed interventions (eg, unstructured lifestyle support, written information with weight monitoring, or behavioral support alone) (−0.74 kg; 95% CI, −1.06 to −0.43). Diet was associated with reduced risk of gestational diabetes (OR, 0.61; 95% CI, 0.45-0.82), preterm delivery (OR, 0.43; 95% CI, 0.22-0.84), large for gestational age neonate (OR, 0.19; 95% CI, 0.08-0.47), neonatal intensive care admission (OR, 0.68; 95% CI, 0.48-0.95), and total adverse maternal (OR, 0.75; 95% CI, 0.61-0.92) and neonatal outcomes (OR, 0.44; 95% CI, 0.26-0.72). Physical activity was associated with reduced GWG and reduced risk of gestational diabetes (OR, 0.60; 95% CI, 0.47-0.75), hypertensive disorders (OR, 0.66; 95% CI, 0.48-0.90), cesarean section (OR, 0.85; 95% CI, 0.75-0.95), and total adverse maternal outcomes (OR, 0.78; 95% CI, 0.71-0.86). Diet with physical activity was associated with reduced GWG (−1.35 kg; 95% CI, −1.95 to −0.75) and reduced risk of gestational diabetes (OR, 0.72; 95% CI, 0.54-0.96) and total adverse maternal outcomes (OR, 0.81; 95% CI, 0.69-0.95). Mixed interventions were associated with reduced GWG on...

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Section: Resultsmentioning

confidence: 99%

“…In the 2017 systematic review, 103 studies were identified, of which 89 were eligible . The 28 new and 89 previous articles were combined for a total of 117 studies for the present meta-analysis . The PRISMA diagram is presented in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes

et al. 2022

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“…Study characteristics are presented in Table 2. Intervention types were structured diet in 13 studies, structured physical activity in 42 studies, diet with physical activity with at least 1 element structured in 16 studies, and mixed interventions that did not meet these criteria in 28 studies . Forty-one studies were conducted in Europe, 34 in the Americas, 13 in Oceania, and 11 in Asia.…”

Section: Resultsmentioning

confidence: 99%

Implementation of Antenatal Lifestyle Interventions Into Routine Care

et al. 2022

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ImportanceLifestyle interventions in pregnancy optimize gestational weight gain and improve pregnancy outcomes, with implementation recommended by the US Preventive Services Task Force. Yet, implementation research taking these efficacy trials into pragmatic translation remains limited.ObjectiveTo evaluate success factors for implementing pregnancy lifestyle interventions into antenatal care settings in a meta-analysis, using the penetration, implementation, participation, and effectiveness (PIPE) impact metric.Data SourcesData from a previous systematic review that searched across 9 databases, including MEDLINE, Embase, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, and Health Technology Assessment Database, were obtained, in 2 stages, up to May 6, 2020.Study SelectionRandomized clinical trials reporting gestational weight gain in singleton pregnancies.Data Extraction and SynthesisThe association of penetration, implementation, and participation with effectiveness of antenatal lifestyle interventions in optimizing gestational weight gain was estimated using random-effects meta-analyses. The Cochrane risk of bias tool, version 1.0, was used to assess risk of bias.Main Outcomes and MeasuresPenetration (reach), implementation (fidelity), participation, and effectiveness of randomized clinical trials of lifestyle interventions in pregnancy.ResultsNinety-nine studies with 34 546 participants were included. Only 14 studies reported penetration of target populations. Overall, 38 studies (38.4%) had moderate fidelity, 25 (25.2%) had high fidelity, and 36 (36.4%) had unclear fidelity. Participation was reported in 84 studies (84.8%). Lifestyle interventions were associated with reducing gestational weight gain by 1.15 kg (95% CI, –1.40 to –0.91 kg).Conclusions and RelevanceThe findings of this systematic review and meta-analysis suggest that, despite the large body of evidence on efficacy of lifestyle interventions during pregnancy in optimizing gestational weight gain, little guidance is available to inform implementation of this evidence into practice. There is a need to better elucidate implementation outcomes in trial design alongside pragmatic implementation research to improve the health of women who are pregnant and the next generation.

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“…Excessive gestational weight gain is associated with hypertension and pre‐eclampsia (Ebadi & Rahmanian, 2009; Hutcheon et al, 2018), gestational diabetes (Liu et al, 2014), increased risk of caesarean section (Wells et al, 2019), urinary tract infection (Ebadi & Rahmanian, 2009), fetal overweight and macrosomia (Gaudet et al, 2014) and post‐partum weight retention. In addition, EGWG leads to long‐term complications such as diabetes, cardiovascular disease, endocrine diseases, musculoskeletal disorders and some cancers (Kiani Asiabar et al, 2018). Excessive gestational weight gain can also lead to overweight and obesity in childhood and adulthood in the offspring (Voerman et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Excessive gestational weight gain can also lead to overweight and obesity in childhood and adulthood in the offspring (Voerman et al, 2019). The use of medical services to eliminate these complications has a negative effect on the economic situation of the family and society (Kiani Asiabar et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Association of maternal and umbilical cord blood asprosin with excessive gestational weight gain

et al. 2022

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Maternal obesity and excessive gestational weight gain (EGWG) may have persistent effects on offspring obesity and be risk factors for both mother and child. Studies have reported that asprosin concentration is associated with metabolism and weight changes during pregnancy. This study therefore evaluated the association of maternal and newborn asprosin with normal weight gain and EGWG and nutritional intake in pregnancy. The study included 30 pregnant women with normal weight gain and 30 women with EGWG referred to Ali ibn Abi Talib Hospital in Zahedan, Iran, September 2020 to June 2021. A demographic questionnaire and neonatal complications checklist were completed. Asprosin concentrations at the time of delivery in maternal venous blood samples and umbilical vein blood samples were measured by ELISA technique. Macronutrient and energy intake were assessed by a 24-h dietary recall questionnaire and compared with standard Recommended Dietary Allowance (RDA) and Dietary References Intake (DRI) values. Asprosin levels were significantly higher in the EGWG group's umbilical cord blood than in the control group but there was no difference in maternal asprosin concentrations between the two groups. The Appearance, Pulse, Grimace, Activity and Respiration (Apgar) score was significantly lower in the EGWG group than in the control group, although there was no difference in birthweight between the groups. Weight gain during pregnancy, energy intake and protein and carbohydrate consumption were significantly higher in the EGWG group than in the control group (p < 0.05). It seems that differences in asprosin secretion do not mediate an imbalance in energy intake and other macronutrients during pregnancy that affect pregnancy weight gain and birthweight. However, excessive gestational weight gain was associated with neonatal asprosin levels and newborn Apgar scores.

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The effect of an educational intervention in early pregnancy with spouse's participation on optimal gestational weight gain in pregnancy: a randomized controlled trial

Cited by 6 publications

References 38 publications

Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes

Association of Antenatal Diet and Physical Activity–Based Interventions With Gestational Weight Gain and Pregnancy Outcomes

Implementation of Antenatal Lifestyle Interventions Into Routine Care

Association of maternal and umbilical cord blood asprosin with excessive gestational weight gain

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